Suicidology in First Responders

Shane McFarland

First responders are exposed to substantial occupational stressors and experience a disproportionate burden of physical and mental health sequelae, including suicidal ideation. The purpose of this dissertation is to advance understanding of suicidal ideation and related risk pathways among first responders in Washington State. Three complementary but independent studies were conducted. First, a scoping review of suicide risk and protective correlates among first responders synthesizes the current state of the literature within the framework of the Integrated Motivational Volitional Model of Suicide. Second, a Group Concept Mapping study with first responder leadership identifies and organizes perceived organizational barriers to mental healthcare access, and evaluates the relative importance and commonness of these barriers across sectors in Washington State. Third, a secondary data analysis of compensable workers’ compensation claims examines incidence patterns on physical and mental health-related injuries among firefighters and law enforcement personnel between 2018 and 2022. Findings suggest that organizational and environmental barriers, including gaps in culturally competent care and financially feasible treatment options, play a central role in limiting access to mental healthcare. Leadership perspectives further indicate that stigma, staffing limitations, and structural constraints contribute to both the prevalence and persistence of these barriers in Washington State agencies. Quantitative analysis demonstrates variation in incidence rates across injury classifications, while also reflecting limitations inherent in administrative claims data. Collectively, these studies integrate theoretical, participatory, and epidemiologic approaches to identify modifiable targets for intervention and inform policy and practice aimed at reducing suicide risk among first responders.

Suicidology in First Responders

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